Insulin Resistance Among Patients With Multiple Endocrine Neoplasia Type 1: A Systemic Review and Meta-Analysis.

BACKGROUND/

OBJECTIVE

Multiple endocrine neoplasia type 1 (MEN1) is a hereditary syndrome characterized by predisposition to tumors of parathyroid, pituitary, and enteropancreatic cells. Multiple studies previously showed increased prevalence of insulin resistance and incidence of cardiovascular diseases, decreased life expectancy in patients with MEN1. In this meta-analysis, we aim to further evaluate the extent of insulin resistance among individuals with MEN1.

METHODS

We systematically searched PubMed, Embase, Scopus, Web of Science Core Collection, and the Cochrane Central Register of Controlled Trials (CENTRAL). Studies involving at least 5 patients with MEN1 and reporting on insulin resistance were included. Primary outcome designated as prevalence of insulin resistance. Meta-analyses done and odds ratios were calculated via the random effects model.

RESULTS

Out of 1453 studies, 5 met the inclusion criteria, involving 606 patients with MEN1 and 4431 controls were included in the meta-analysis. Patients with MEN1 had a significantly higher prevalence of insulin resistance with an odds ratio of 5.58 (95% confidence interval [4.02, 7.74]. No heterogeneity was observed (Tau2 = 0, P = 0.4552). Sensitivity analyses confirmed the robustness of findings.

CONCLUSIONS

To our best knowledge, this represents the first meta-analysis on MEN1 and insulin resistance. We have identified a higher prevalence of insulin resistance among individuals with MEN1 compared to controls, independent of age, sex, or body mass index. Given these findings, we recommend that patients with MEN1 should be screened early in the disease course for impaired glucose tolerance, as this may help prevent future cardiovascular events and enhance life expectancy.